Anticoncepción: ¿qué cambia a los 40 años?

Revisión de anticonceptivos con 40 años

Píldora, parche, anillo, DIU…. ¿deberíamos cambiar el método anticonceptivo con el pretexto de que nos acercamos a los 40?. Y sobre todo, ¿cuál elegir?. Respuestas caso por caso.

Si el método anticonceptivo es apropiado, ¿por qué no mantenerlo?. La pregunta surge porque los riesgos asociados con las hormonas aumentan con el tiempo.

“La recomendación es que se reevalue regularmente los anticonceptivos de acuerdo con el perfil de cada paciente, antes y especialmente después de los 40 años”, dice la Dra. Élisabeth Paganelli, ginecóloga. Por lo tanto, es la situación de cada persona la que determina si se debe cambiar o no.

El DIU se elige a menudo

Esta es la solución adoptada por el 35% de las mujeres a esta edad, especialmente aquellas que abandonan la píldora debido a un aumento de sus factores de riesgo vascular. Sin embargo, debe evitarse en casos de infección ginecológica, malformación uterina o agrandamiento del útero (fibroma). La elección entre los dos tipos de DIU depende de su tolerancia. Cada uno tiene sus propias indicaciones y a veces es necesario andar a tientas antes de encontrar la más apropiada.

El DIU (dispositivo intrauterino) con cobre. No libera hormonas y a menudo conduce a una menstruación abundante, por lo que existe el riesgo de anemia debido a la deficiencia de hierro. A veces es necesario realizar un análisis de sangre de antemano.

El DIU de progesterona. Reduce o elimina reglas. Pero en las mujeres que no tienen suficiente estrógeno, esto puede llevar a una recurrencia del síndrome premenstrual. Como esta bobina libera hormonas, está contraindicada en mujeres que han tenido cáncer dependiente de hormonas.

La píldora es a menudo menos adecuada

La píldora de estrógeno y progestágeno aumenta el riesgo de enfermedad cardiovascular, que también es más importante con la edad. Por lo tanto, no se recomienda si existen otros factores de riesgo: tabaquismo, diabetes, colesterol y triglicéridos altos (grasas en sangre), antecedentes de flebitis (coágulo en una vena).

Si quieres mantener un anticonceptivo oral, una píldora de sólo progestina (sin estrógenos) puede tomar el control. Siempre que no tenga insuficiencia cardíaca y no haya tenido un cáncer hormonodependiente (mama, ovarios). De lo contrario, no hay razón para cambiar las píldoras a los 40 años.

Tenga cuidado con los parches y los anillos

Incluso si es local (en la piel para el parche, en la vagina para el anillo), ellos liberan hormonas: estrógeno y progestina. Por lo tanto, su efecto sobre el cuerpo es idéntico al de la píldora. Por esta razón, tampoco se recomiendan si los factores de riesgo han aumentado. Entonces es mejor cambiar a otro método anticonceptivo.

Esterilización, también una solución……

Ella tienta a algunas mujeres que ya no están considerando tener hijos.

Hay dos métodos disponibles: ligadura de trompas por laparoscopia (bajo anestesia general) o colocación del implante Essure en las trompas, bajo anestesia local. Esta técnica ha suscitado recientemente algunas dudas, ya que algunas mujeres han experimentado efectos secundarios. Pero, según los expertos en ginecologia, las complicaciones siguen siendo raras y el método puede seguir siendo propuesto.

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